Basic Information
Provider Information
NPI: 1407276025
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MEADORS
FirstName: STEVEN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5 SAINT VINCENT CIR STE 501
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722055414
CountryCode: US
TelephoneNumber: 5016662894
FaxNumber: 5016669017
Practice Location
Address1: 5 SAINT VINCENT CIR STE 501
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722055414
CountryCode: US
TelephoneNumber: 5016662894
FaxNumber: 5016669017
Other Information
ProviderEnumerationDate: 04/22/2014
LastUpdateDate: 07/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2086S0129XE-14154ARY Allopathic & Osteopathic PhysiciansSurgeryVascular Surgery

No ID Information.


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